Mushaphi, L. F.Mabapa, N. S.Mudau, Zwivhuya Patience2026-06-182026-06-182026-05-19Mudau, Z.P. 2026. Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa. . .https://univendspace.univen.ac.za/handle/11602/3237M.Sc. in NutritionDepartment of NutritionBackground Stunting is the most prevalent form of chronic undernutrition affecting over 165 million children under five years of age globally (WHO, 2006). In 2017, an estimated 1 in every 4 (23%) children aged < 5 years were stunted worldwide (Budge et al., 2019). The study aims to assess biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months. Methodology A quantitative cross-sectional study was conducted among 396 infants aged 3–9 months residing in the Thulamela Municipality. Simple random sampling was used to select six clinics per cluster, for a total of 36 clinics. Convenience sampling was used to select 396 infants aged 3–9 months. A researcher-administered questionnaire was used to gather socio-demographic and anthropometric data from the infants. The questionnaire consisted of three sections, namely, section A: which solicited socio-demographic information such as age of infants, birth weight, birth length and immunisation, which was collected from the Road to Health Booklet, section B: where feeding practices information was collected and section C: Record sheet, where anthropometric measurements and blood samples collection were recorded. A phlebotomist collected blood samples from the infants to determine haemoglobin (Hb), ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP-4), thyroglobulin (Tg), C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP). IBM Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. Blood samples were analysed at a specialised human lab at Northwest University (NWU). Data was checked for normality using the Kolmogorov-Smirnov test. Data distributed normally were presented as means with standard deviations (SD), while non-normally distributed data were presented as median values with interquartile ranges (IQRs). Categorical data were presented as frequencies. Results More than half (50.7%) of mothers knew about breastfeeding, and they mentioned health workers as their source of information. More than half of the mothers had grades 11-12, almost a quarter had tertiary education. More than three-quarters (76.4%) of mothers-initiated breastfeeding immediately after delivery. More than half (50.7%) of the mothers introduced their infants to solid foods at 4–6 months of age. More than a quarter (30.7%) of mothers cited “infant is crying a lot” as a reason for introducing solid foods and fluids. More than a quarter (38.2%) of the mothers fed their infants breast milk and maize meal soft porridge. Majority of infants (96.4%) had sufficient vitamin A. More than a quarter (30.1%) of infants were stunted, 22.2% were underweight while 10.7% of infants were overweight. The majority (68.5%) of infants had low IGF-1 levels, while only 30% had normal levels. About 73.1% of the infants had high FGF-21 levels, 3.6% had normal levels, and only 23.4% had low levels. majority of infants (73.1%) had high IFABP levels, 3.6% had normal levels, and only 23.4% had low levels. About 47.2% of the infants had low CD-14 concentrations, 42.1% had normal concentrations, and 10.7% had high concentrations. Conclusion The results of the study show that mothers have breastfeeding knowledge however complementary feeding knowledge appears to be lacking. The growth status of infants is generally good however, stunting (16.7%) and wasting (5.1%) was observed. The education level of mothers may have contributed to the low prevalence of stunting and wasting. It is concluded that infants in Thulamela have anaemia (84.4% combined). There is good reason for concern about the risks of anaemia. Iron deficiency (ID) as indicated by ferritin and soluble transferrin receptor (sTfR) show that Iron deficiency (ID) exists in infants of Thulamela. The Tg results show that half of the infants had insufficient iodine, and this is a concern given consequences of iodine deficiency. The study results also indicate a growth hormone deficiency, as evidenced by low IGF-1 levels which may hinder linear growth, impair cognitive development, and weaken immune responses to pathogen exposure. The findings also show elevated FGF-21 levels which are associated with an increased risk of growth faltering, particularly during nutritional supplementation. The results of the study show elevated IFABP levels, indicating a compromised gut barrier and associated with poor nutritional status and a higher risk of malnutrition. The study reveals that fewer than 25% of infants showed elevated plasma CD14 levels, which are linked to inadequate nutrition, obesity, and inflammation. This study observed obesity and overweight, suggesting that increased CD14 levels may stem from these conditions in infants.1 online resource (xiv, 121 leaves)enUniversity of VendaStuntingEnvironmental enteric dysfunctionVitamin AFibroblast growth factor 21 (FGF-21)Intestinal fatty acid binding protein (IFABP)DissertationMudau ZP. Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa. []. , 2026 [cited yyyy month dd]. Available from:Mudau, Z. P. (2026). <i>Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa</i>. (). . Retrieved fromMudau, Zwivhuya Patience. <i>"Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa."</i> ., , 2026.TY - Dissertation AU - Mudau, Zwivhuya Patience AB - Background Stunting is the most prevalent form of chronic undernutrition affecting over 165 million children under five years of age globally (WHO, 2006). In 2017, an estimated 1 in every 4 (23%) children aged < 5 years were stunted worldwide (Budge et al., 2019). The study aims to assess biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months. Methodology A quantitative cross-sectional study was conducted among 396 infants aged 3–9 months residing in the Thulamela Municipality. Simple random sampling was used to select six clinics per cluster, for a total of 36 clinics. Convenience sampling was used to select 396 infants aged 3–9 months. A researcher-administered questionnaire was used to gather socio-demographic and anthropometric data from the infants. The questionnaire consisted of three sections, namely, section A: which solicited socio-demographic information such as age of infants, birth weight, birth length and immunisation, which was collected from the Road to Health Booklet, section B: where feeding practices information was collected and section C: Record sheet, where anthropometric measurements and blood samples collection were recorded. A phlebotomist collected blood samples from the infants to determine haemoglobin (Hb), ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP-4), thyroglobulin (Tg), C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP). IBM Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. Blood samples were analysed at a specialised human lab at Northwest University (NWU). Data was checked for normality using the Kolmogorov-Smirnov test. Data distributed normally were presented as means with standard deviations (SD), while non-normally distributed data were presented as median values with interquartile ranges (IQRs). Categorical data were presented as frequencies. Results More than half (50.7%) of mothers knew about breastfeeding, and they mentioned health workers as their source of information. More than half of the mothers had grades 11-12, almost a quarter had tertiary education. More than three-quarters (76.4%) of mothers-initiated breastfeeding immediately after delivery. More than half (50.7%) of the mothers introduced their infants to solid foods at 4–6 months of age. More than a quarter (30.7%) of mothers cited “infant is crying a lot” as a reason for introducing solid foods and fluids. More than a quarter (38.2%) of the mothers fed their infants breast milk and maize meal soft porridge. Majority of infants (96.4%) had sufficient vitamin A. More than a quarter (30.1%) of infants were stunted, 22.2% were underweight while 10.7% of infants were overweight. The majority (68.5%) of infants had low IGF-1 levels, while only 30% had normal levels. About 73.1% of the infants had high FGF-21 levels, 3.6% had normal levels, and only 23.4% had low levels. majority of infants (73.1%) had high IFABP levels, 3.6% had normal levels, and only 23.4% had low levels. About 47.2% of the infants had low CD-14 concentrations, 42.1% had normal concentrations, and 10.7% had high concentrations. Conclusion The results of the study show that mothers have breastfeeding knowledge however complementary feeding knowledge appears to be lacking. The growth status of infants is generally good however, stunting (16.7%) and wasting (5.1%) was observed. The education level of mothers may have contributed to the low prevalence of stunting and wasting. It is concluded that infants in Thulamela have anaemia (84.4% combined). There is good reason for concern about the risks of anaemia. Iron deficiency (ID) as indicated by ferritin and soluble transferrin receptor (sTfR) show that Iron deficiency (ID) exists in infants of Thulamela. The Tg results show that half of the infants had insufficient iodine, and this is a concern given consequences of iodine deficiency. The study results also indicate a growth hormone deficiency, as evidenced by low IGF-1 levels which may hinder linear growth, impair cognitive development, and weaken immune responses to pathogen exposure. The findings also show elevated FGF-21 levels which are associated with an increased risk of growth faltering, particularly during nutritional supplementation. The results of the study show elevated IFABP levels, indicating a compromised gut barrier and associated with poor nutritional status and a higher risk of malnutrition. The study reveals that fewer than 25% of infants showed elevated plasma CD14 levels, which are linked to inadequate nutrition, obesity, and inflammation. This study observed obesity and overweight, suggesting that increased CD14 levels may stem from these conditions in infants. DA - 2026-05-19 DB - ResearchSpace DP - Univen KW - Stunting KW - Environmental enteric dysfunction KW - Vitamin A KW - Fibroblast growth factor 21 (FGF-21) KW - Intestinal fatty acid binding protein (IFABP) LK - https://univendspace.univen.ac.za PY - 2026 T1 - Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa TI - Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa UR - ER -